The latest findings stem from the continued follow-up of breastfeeding
mothers and their babies enrolled in a clinical trial (HIVNET 012). The
trial was supported by the National Institute of Allergy and Infectious
Diseases (NIAID), part of the U.S. National Institutes of Health. Last
year, results from that trial
(http://www.niaid.nih.gov/cgi-shl/simple/release.cfm ) showed that a short
regimen of nevirapine given to both mother and child significantly reduced
HIV transmission. Today's announcement reported that this reduction in
mother-to-infant transmission of HIV was sustained even though the infants
Conducted at the teaching hospital of Makerere University in Kampala,
Uganda, the study compared the safety and efficacy of a short course of
nevirapine with that of another AIDS drug, AZT. One group of women received
a single dose of nevirapine during labor and their infants received one dose
within 72 hours of birth. The second group of women received AZT during
labor while their newborns received twice daily doses for 7 days. After 6-8
weeks, both regimens were well tolerated, but mothers and infants who
received nevirapine had a 42 percent lower risk of HIV transmission when
compared with those receiving AZT.
New data on those same infants 12 months later show nevirapine continues to
reduce risk of HIV transmission over AZT. After 6-8 weeks, nevirapine
showed a 42 percent reduction in HIV transmission compared to AZT. At 12
months, the reduction was 39 percent, and preliminary results indicate a
reduction of 42 percent after 18 months. In addition, the benefits of
nevirapine occurred despite breastfeeding by the women in the study.
Genetic analysis of HIV in the mothers showed that while a small number of
mutations do occur in the virus that make it impervious to the drug, those
mutations fade from detection within 13-18 months after delivery. This
suggests that repeat doses of nevirapine given to the mother will continue
to prevent HIV transmission during future pregnancies.
Researchers also assessed how well the amount of HIV and CD4 T-cells in the
mother's blood would predict the likelihood of her passing the virus on to
her baby. Women with more virus and fewer CD4 T-cells in their blood were
more likely to transmit HIV to their offspring than were those with less
virus and more CD4 cells.
Together, these findings further indicate that a short nevirapine regimen is
an effective, simple, and extremely low cost method for preventing
transmission of HIV from mother to child in developing countries.
The trial was led by Dr. Brooks Jackson at The Johns Hopkins University and
Professor Francis Mmiro at Makerere University. Statistical analysis was
coordinated by Dr. Tom Fleming at the Fred Hutchinson Cancer Research Center
NIAID is a component of the National Institutes of Health (NIH). NIAID
conducts and supports research to prevent, diagnose, and treat illness such
as HIV disease and other sexually transmitted diseases, tuberculosis,
malaria, asthma and allergies. NIH is an agency of the U.S. Department of
Health and Human Services.
Press releases, fact sheets and other NIAID-related materials are available
on the NIAID Web site at http://www.niaid.nih.gov.
The National Institute of Allergy and Infectious Diseases is a component of
the National Institutes of Health, U.S. Department of Health and Human